REVASK SURGERY CENTER LLC
NPI 1396238010
Clinic/Center - Ambulatory Surgical in Wichita, KS

NPI Status: Active since June 07, 2018

Contact Information

2122 N GARNETT ST
WICHITA, KS
ZIP 67206
Phone: (316) 636-1234
Fax: (316) 636-2630

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  • Organization
  • Clinic/Center
  • Ambulatory Surgical
  • Accepts Insurance
  • CLIA Number: 17D2160355
  • CLIA Cert. Type: Ambulatory Surgery Center
  • CLIA Exp. Date: 01-08-2027

About REVASK SURGERY CENTER LLC

This page provides the complete NPI Profile along with additional information for Revask Surgery Center Llc, a provider established in Wichita, Kansas operating as a Clinic/center, focusing in ambulatory surgical . The healthcare provider is registered in the NPI registry with number 1396238010 assigned on June 2018. The practitioner's primary taxonomy code is 261QA1903X with license number 04-35548 (KS). The provider is registered as an organization and their NPI record was last updated 5 years ago. The provider's is doing business as Revask Surgery Center Llc. The authorized official of this NPI record is Wissam Saliba Md (Director)

NPI
1396238010
Provider Legal Name
WICHITA NEPHROLOGY GROUP, PA
Other Organization Name
REVASK SURGERY CENTER LLC
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
2122 N GARNETT ST WICHITA, KS 67206
Location Phone
(316) 636-1234
Location Fax
(316) 636-2630
Mailing Address
2122 N GARNETT ST WICHITA, KS 67206
Mailing Phone
(316) 263-5891
Mailing Fax
(316) 636-2630
Is Sole Proprietor?
No
Is Organization Subpart?
Yes
Enumeration Date
06-07-2018
Last Update Date
03-29-2021
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Ambulatory Surgical

Taxonomy Code
261QA1903X
Type
Ambulatory Health Care Facilities
License No.
04-35548
License State
KS

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Complete Silver - EPO
  • Complete Silver + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • Choice Bronze HSA - EPO
  • Choice Bronze HSA + Vision + Adult Dental - EPO
  • Clear Gold - EPO
  • Clear Gold + Vision + Adult Dental - EPO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Elite Bronze - EPO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Clear Gold - EPO
  • Clear Gold + Vision + Adult Dental - EPO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Elite Silver - EPO
  • Elite Silver + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • Elite Bronze - PPO
  • Elite Bronze + Vision + Adult Dental - PPO
  • Elite Gold - PPO
  • Elite Gold + Vision + Adult Dental - PPO
  • Enhanced Asthma/COPD Care Silver with $0 Drug Options - PPO
  • Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental - PPO
  • Enhanced Diabetes Care Silver with $0 Drug Options - PPO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - PPO
  • Everyday Bronze - PPO
  • Everyday Bronze + Vision + Adult Dental - PPO
  • BlueCare EPO Bronze - EPO
  • BlueCare EPO Gold - EPO
  • BlueCare EPO Gold Plus - EPO
  • BlueCare EPO Silver Plus - EPO
  • BlueCare EPO Simple Bronze HDHP - EPO
  • BlueCare EPO Simple Silver HDHP - EPO
  • BlueCare EPO Standardized Expanded Bronze - EPO
  • BlueCare EPO Standardized Gold - EPO
  • BlueCare EPO Standardized Silver - EPO
  • UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - EPO
  • UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
  • UHC Bronze Essential (No Referrals) - EPO
  • UHC Bronze Standard (No Referrals) - EPO
  • UHC Bronze Standard+ (Dental + Vision, No Referrals) - EPO
  • UHC Gold Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - EPO
  • UHC Gold Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - EPO
  • UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - EPO
  • UHC Gold Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - EPO
  • UHC Gold Standard (No Referrals) - EPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

WISSAM SALIBA MD

Authorized Official Title
DIRECTOR
Authorized Official Phone
(316) 263-5891

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Balloon dilation of vein with review by radiologist, initial vein

Balloon dilation of a vein is a procedure where a small balloon is inserted into a narrowed vein. Once in place, the balloon is inflated to widen the vein and improve blood flow. The procedure is overseen by a radiologist, who uses imaging techniques to ensure accurate placement of the balloon. This is done on the initial vein requiring treatment.

This service was performed 26 times for 21 patients

Complete ultrasound of artery and vein blood flow pre-op assessment on both sides of body for hemodialysis access

This procedure involves using ultrasound technology to examine the blood flow in your arteries and veins on both sides of your body. It's crucial for preparing for hemodialysis access, ensuring safe and effective treatment.

This service was performed 61 times for 61 patients

Injection, alteplase recombinant, 1 mg

Alteplase recombinant is a medication given by injection. It's a clot-busting drug used to treat conditions like strokes or heart attacks by dissolving blood clots that block blood flow. The dose is typically 1 mg. It's crucial to administer it quickly after symptoms appear.

This service was performed 18 times for 11 patients

Insertion of needle and/or tube into hemodialysis circuit and balloon dilation of dialysis segment with review by radiologist

This procedure involves inserting a needle or tube into your hemodialysis circuit, a system that cleans your blood when your kidneys can't. A balloon is then used to widen a narrow section of this circuit. A radiologist reviews the procedure to ensure accuracy.

This service was performed 269 times for 164 patients

Insertion of needle and/or tube into hemodialysis circuit and insertion of stent in dialysis segment with review by radiologist

This procedure involves placing a needle or tube into your hemodialysis circuit, a system used to clean your blood when kidneys are not working properly. A stent, a small tube, is then inserted into the dialysis segment to keep it open. A radiologist reviews the process to ensure accuracy.

This service was performed 42 times for 34 patients

Insertion of needle and/or tube into hemodialysis circuit with review by radiologist

This procedure involves inserting a needle or tube into your hemodialysis circuit, which is part of the system that cleans your blood when your kidneys can't. A radiologist, a doctor specialized in imaging techniques, will review the process to ensure everything is correct.

This service was performed 84 times for 60 patients

Insertion of tube for infusion (5 years or older)

This procedure involves placing a small, flexible tube into a vein, usually in the arm. It's done to allow quick, efficient delivery of fluids or medications directly into the bloodstream. It's a common, safe process that helps manage various health conditions.

This service was performed 18 times for 17 patients

Insertion of tunneled central venous tube for infusion (5 years or older)

The insertion of a tunneled central venous tube is a procedure where a thin, flexible tube is placed into a large vein, usually in the neck or chest. This tube allows healthcare providers to give medications, fluids, or nutrients directly into your bloodstream over a longer period.

This service was performed 34 times for 33 patients

Removal and/or dissolving of blood clot in hemodialysis circuit and balloon dilation of dialysis segment and placement of stent with review by radiologist

This is a procedure to improve your dialysis treatment. If a blood clot blocks your dialysis circuit, it's removed or dissolved. If the dialysis segment is narrow, a balloon is used to widen it. Sometimes, a stent is placed to keep it open. A radiologist reviews all these steps to ensure accuracy.

This service was performed 19 times for 19 patients

Removal and/or dissolving of blood clot in hemodialysis circuit and balloon dilation of dialysis segment with imaging review by radiologist, with balloon tube

This procedure involves eliminating a blood clot in your hemodialysis circuit, ensuring smooth blood flow. A balloon tube is used to widen the dialysis segment if needed. Images are taken and reviewed by a radiologist to confirm successful completion.

This service was performed 51 times for 37 patients

Removal of tunneled central venous tube

A tunneled central venous tube removal is a procedure to take out a long, thin tube that was previously placed in a large vein in your body. This tube helps deliver medication or nutrition. The removal is usually quick and done under local anesthesia.

This service was performed 56 times for 56 patients

Replacement of tunneled central venous tube

A tunneled central venous tube replacement is a procedure where an existing tube, used to deliver medication or nutrition directly to a large vein, is replaced. This is done under local anesthesia and involves inserting a new tube through a small incision.

This service was performed 58 times for 43 patients

Review by radiologist of both arms and legs veins of both arms or legs image

This procedure involves a radiologist examining images of veins in your arms and legs. These images can help identify any abnormalities or issues with blood flow. The process is non-invasive and painless, providing valuable information for your healthcare.

This service was performed 57 times for 57 patients

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
17D2160355
Facility Type
Ambulatory Surgery Center
Certificate Effective Date
January 09, 2025
Certificate Expiration Date
January 08, 2027
Laboratory Director
WISSAM SALIBA
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Revask Surgery Center Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1396238010, we treat the final digit (0) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 60. The final step is to find the difference between that total and the next multiple of ten (60 - 60 = 0).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
3
Unchanged
Pos 3
9
Doubled → 18 → 1 + 8
Pos 4
6
Unchanged
Pos 5
2
Doubled → 4
Pos 6
3
Unchanged
Pos 7
8
Doubled → 16 → 1 + 6
Pos 8
0
Unchanged
Pos 9
1
Doubled → 2
Check
0
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 9 → 18 → 9 2 → 4 8 → 16 → 7 1 → 2

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 3 + 1 + 8 + 6 + 4 + 3 + 1 + 6 + 0 + 2 + 24 = 60

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 60 is 60. The difference is the calculated check digit.

60 - 60 = 0
This NPI is valid
The calculated check digit is 0, which matches the last digit of 1396238010.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1396238010, enumerated as an "organization" on June 07, 2018.

The provider is located at 2122 N GARNETT ST WICHITA, KS 67206 and the phone number is (316) 636-1234.

Clinic/Center with taxonomy code 261QA1903X and a focus in Ambulatory Surgical.

The provider might be accepting Accepts: Ambetter from Home State Health, Ambetter from. Please consult your insurance carrier or call the provider to verify.